Covid-19 Update
Debate between Baroness Browning and Lord Bethell(3 years, 4 months ago)
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Lord Bethell (Con)
My Lords, the registration of people going into events is an onerous responsibility for the hospitality industry and we have to make a proportionate assessment of what kinds of burden we are putting on the economy and society. With more than 60% of the population now having been double vaccinated for over two weeks and with the vaccination programme going along at 500,000 a day, it is the moment to start backing off on some of these obligations. That means dismantling some of the infrastructure of test and trace, which we seek to do in a proportionate and logical fashion.
Baroness Browning (Con) [V]
Given the prediction of increased infectivity, what internal guidance is being given post 19 July within the NHS? Will GP surgeries, A&E and outpatient departments revert to their former practices, or is the guidance that they should retain face masks, distancing and hand gel use?
Lord Bethell (Con)
My Lords, on the three specific locations the noble Baroness asked about, I understand that those practices will remain in place, but I am happy to check that and write to her. As for going back to where we were before, I think some things will change for ever.
Covid-19: Proof of Vaccination
Debate between Baroness Browning and Lord Bethell(3 years, 5 months ago)
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Lord Bethell (Con)
My Lords, that is not our approach. Our approach is to try to use whatever technologies work in order to open up our borders. The idea that 30% of tests are not correct is an unhelpful suggestion by the noble Lord. We will be using testing in the validation app.
Baroness Browning (Con) [V]
My Lords, I declare my interest as a vice-president of the National Autistic Society. My noble friend will be only too well aware that many on the autism spectrum are very IT-savvy. However, can he help those who would find it quite a challenge to phone 111? Is there any way the Government can communicate with the autism community, perhaps through the charitable sector and others, to make alternative arrangements other than just a phone call?
Lord Bethell (Con)
My Lords, we have engaged considerably with the sector on exactly these kinds of matters. GPs and pharmacies are briefed to help those with difficulties get this material. We are also conscious that some with autism may struggle to take a test and find the process of swabbing intimidating, so we are looking into workarounds for that.
Social Care: Person-centred Dementia Care
Debate between Baroness Browning and Lord Bethell(3 years, 6 months ago)
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, we want a society where every person with dementia—and their families and carers—receives high-quality, compassionate care from diagnosis to the end of their life. The Government are committed to sustainable improvement of the adult care system and will bring forward proposals in 2021. We are working closely with local and national partners such as the Alzheimer’s Society to ensure that our approach to reform is informed by diverse perspectives, including those with lived experience of the care sector.
Baroness Browning (Con) [V]
My Lords, I refer to my interests in the register as an ambassador for the Alzheimer’s Society and as a carer. This is Dementia Action Week. I am grateful to my noble friend and urge him that, as people with dementia are by far the majority of users of social care, the promised reforms deliver person-centred care to enable people with dementia to live in places they call home, take part in activities they enjoy and live their lives safely with meaning, purpose and connection with others.
Lord Bethell (Con)
My Lords, I am extremely grateful to my noble friend for raising Dementia Action Week, a time to celebrate the contribution of those who care for people with these conditions. I know from my own experience the incredible importance of personalised care and of being able to have loved ones at home for as long as they can safely and reasonably be cared for there. My noble friend puts the experience of living with dementia for families and carers extremely well. I entirely endorse her sentiments.
World Health Organization: Pandemics
Debate between Baroness Browning and Lord Bethell(3 years, 8 months ago)
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Lord Bethell (Con)
My Lords, the WHO is not a sitting member of the G7, but we have a representative attending our health track in Oxford, and we have been in dialogue with them directly with our agenda on the G7.
Baroness Browning (Con) [V]
The WHO website officially states that, on 30 January, it declared a public health emergency of international concern. It claims that not many countries took much notice and that it was not until it used the word “pandemic”, on 11 March, five weeks later, that people sat up and took notice. This is clearly unsatisfactory. Will my noble friend do all that he can, as I hope he will, to ensure that the system of notification is improved at the earliest opportunity?
Lord Bethell (Con)
My Lords, my noble friend is right in her chronology, but we want the WHO to continue to learn lessons on how to improve its response to global health emergencies in the early stage. The delay in that global response is something that the WHO needs to learn from.
Covid-19: Vaccine
Debate between Baroness Browning and Lord Bethell(3 years, 10 months ago)
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Lord Bethell (Con)
The noble Lord alludes to a complicated dilemma that we all feel. I welcome challenge and those who query and question the basis of our policy decisions and our science. He is right: too much false information and fake news can damage trust. We have gone about the vaccine process with an approach that is as open and transparent as it can possibly be. We have sought to engage in dialogue and answer questions where there have been any. That approach has proved to be effective and it is the one we continue with.
Baroness Browning (Con) [V]
My husband, who is 84 years old, received his Pfizer vaccine before Christmas and his second one last week was cancelled. Is there any guarantee that, when the second jab comes, it will be the Pfizer vaccine? As I understand, there has been no research on mixing and matching these vaccines. Is there any way that the level of immunity can be tested at that three-month point?
Lord Bethell (Con)
The CMO has made it clear that he leans heavily towards having consistent vaccines, but it is not a requirement. Some of the immune response comes from antibodies which can be tested, but some of it is from T-cells, which are very difficult to test for. It is not possible to categorically say whether someone is immune. However, we have looked at ways to measure and understand more about the body’s immune response to develop our understanding in this area.
Care Quality Commission Report
Debate between Baroness Browning and Lord Bethell(3 years, 11 months ago)
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Lord Bethell (Con) [V]
My Lords, I would be grateful to hear from the Rights for Residents campaign, which sounds like an important and valuable contribution. I reassure the noble Baroness that the numbers of those who have undergone restrictive practices who have autism or learning difficulties do not appear to have risen during the pandemic. That is not to say that the current numbers are acceptable.
Baroness Browning (Con) [V]
My Lords, I refer to my interests in the register. My noble friend has not mentioned—and I would like to remind him of it—that in 2009 Parliament passed the Autism Act. It is the only medically diagnosed condition, apart from mental health, considered important enough to have its own Act of Parliament. Many of the issues raised in the CQC report to do with diagnosis and failure to intervene at an early stage with appropriate and timely interventions are covered in the Autism Act. Will he ask his department to look again at that Act, which is subject to ministerial guidance, and make sure that not only is it implemented but there is sufficient funding for that Act to be put into practice?
Lord Bethell (Con) [V]
I am very grateful for the reminder from the noble Baroness, and I would be glad to take her recommendation back to the department and write to her on whether there are any measures that we need to put in place to ensure that we are fulfilling our commitments under the Autism Act. It was an important Act, and I suspect that we are well within the measures that it has enacted.
Face-to-Face Medical Appointments
Debate between Baroness Browning and Lord Bethell(4 years ago)
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Lord Bethell (Con)
The noble Lord makes an incredibly interesting parallel with Iceland. It is not one that I knew, but I will take care to look into it, because it is instructive and informative. He is right to say that Covid has demonstrated the power of telemedicine, and we are keen to learn that lesson. We do not want the elastic band of old practice to snap back to where it was before. To reflect the words of a noble Lord who spoke previously, there will be occasions when tele- medicine is right. The key is getting the blend correct and ensuring that the right format is used in the right circumstances.
Baroness Browning (Con) [V]
I quite accept that there is a role for telemedicine, but an accurate diagnosis in cases of serious disease and illness is dependent not just on the questions that the doctor asks and the observations he makes but on the ability of the patient to give accurate information. I will give the example from my family in the past few months of antibiotics prescribed for a “lung infection” that was actually a fatal pulmonary embolism. Getting that mix right is not easy; there are very many shades of grey.
Lord Bethell (Con)
My noble friend makes a very good point. Diagnosis is phenomenally difficult and, quite often, patients who present with seemingly one condition have something altogether different. It may be that a face-to-face appointment will be the moment when that difference is spotted and caught. She is entirely right to say that we cannot omit that format for the right circumstances, but a great many patients see their GPs very regularly. Their journeys may be onerous, uncomfortable and stressful, and telemedicine might offer them an alternative opportunity. There are others for whom speed is of the essence, and having telemedicine, particularly when it is supported by apps that provide essential information about their condition, can be an important and urgent alternative.
Hospitals and Nursing Homes: Do Not Resuscitate Notices
Debate between Baroness Browning and Lord Bethell(4 years, 1 month ago)
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Baroness Browning (Con) [V]
My Lords, I beg leave to ask the Question standing in my name on the Order Paper and refer to my interests in the register.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, the department is very clear that the blanket use of DNACPR and DNR is unacceptable. An agreement to a DNACPR is an individual decision and should involve the person concerned or, where the person lacks capacity, their family, carer, guardian or any other legally recognised advocate. I can inform the House that the Minister for Patient Safety and Mental Health will be writing to the Care Quality Commission requesting that it investigates and reports on DNACPR issues.
Baroness Browning (Con) [V]
I am grateful to my noble friend and am aware of the letters written in respect of people with learning disabilities and autism during the first phase of the Covid-19 outbreak. However, with the second wave looking as though it is on its way, my noble friend will be aware that there is still concern from charities such as Mencap and the National Autistic Society, not least because of the attitude in some areas that people who have social care support needs are rather lesser human beings than the rest of us. How will the Care Quality Commission carry out this assessment as the second wave increases?
Lord Bethell (Con)
My Lords, it is completely unacceptable for any group of people to have blanket DNACPR provisions apply to them. The adult social care winter plan published on 18 September reiterates that and makes the position crystal clear. The General Medical Council is providing additional support and guidance to clinicians on how to meet the needs of patients and relatives, and the Resuscitation Council UK is creating a large amount of resources to provide training. The CQC is monitoring the situation extremely carefully.
Covid-19: NHS Long-term Plan
Debate between Baroness Browning and Lord Bethell(4 years, 2 months ago)
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Lord Bethell (Con)
My Lords, the right reverend Prelate is right; health inequalities are a massive priority for the Government. Covid has demonstrated how health inequalities play out when an epidemic such as this one hits the country. That is why we put education and levelling-up on health generally as major government priorities, why we are investing in 50,000 new nurses and 40 new hospitals, and why health remains a number one priority for this Government.
Baroness Browning (Con) [V]
My Lords, my noble friend will be aware that the long-term plan has set an ambitious target for 2028 of 75% of cancers being diagnosed at stages 1 and 2. Does he agree that this must involve GPs, and that GPs having face-to-face consultations with patients is the only way that this target will be achieved?
Lord Bethell (Con)
We are enormously proud of the commitment to early intervention on cancer. This is the absolute core of our life science priorities. It is envisaged that we will have a revolution in the diagnostic capabilities of the NHS in order to hit these targets and, where necessary, face-to-face GP appointments will be made available. However, I am not sure that every single appointment needs to be face to face. One of the learnings of more than half of the 100 million consultations that took place between March and June was that telephone and video appointments can be extremely productive.
Covid-19
Debate between Baroness Browning and Lord Bethell(4 years, 2 months ago)
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Lord Bethell (Con)
The right reverend Prelate is entirely right to raise this point; it is emerging as a massive concern. The idea that Covid will somehow pass through Britain and leave people untouched, a bit like simple winter flu, is beginning to prove worryingly untrue. Her anecdote from Bristol is completely consistent with what we are seeing across the piece. In particular, those who have had acute infection but also, I fear, some who have had relatively asymptomatic or low-symptom Covid have found in later weeks and months symptoms of fatigue, arrythmia, renal impact, scarring on the lungs and memory loss. These are extremely worrying symptoms. Sir Patrick Vallance, the Government Chief Scientific Adviser, is running an operation to understand what the right reverend Prelate rightly calls long Covid; we are using big data to analyse the scans we have collected from acute patients and to understand the impact of asymptomatic infection. This is an extremely worrying manifestation of Covid, one that we are acutely aware of, and we are investigating very urgently.
Baroness Browning (Con) [V]
My noble friend will be only too aware of the consequences of non-Covid patients’ reluctance to present themselves at hospitals and even to GPs for treatment and support. With the winter months approaching, what can he do to make sure that, at a local level, in advance of people having symptoms, they are reassured that they will be safe to approach the NHS? The idea that “it will be all right on the night” and just requires encouragement has clearly not been enough in the past and, I fear, will not be enough in the coming months.
Lord Bethell (Con)
My Lords, my noble friend is entirely right that confidence in attending NHS venues is hard hit by Covid. One of the inspiring and interesting things that has happened has been the switch to using telemedicine—video and telephone calls—for referrals. This has been particularly and interestingly used in mental health, where attendance at clinics is something that many patients would wisely seek to avoid, but in fact the delivery of mental health therapy through telemedicine and calls has proved to be incredibly effective and has worked very well. We are working hard, through the NHS, to try to de-weight attendance at venues, particularly big central hospitals, and move much more towards attendance in the community, or through technology, in order to give patients a choice and to increase our engagement at a time when people are fearful of going back to their GP surgeries.
Covid-19: Personal Protective Equipment
Debate between Baroness Browning and Lord Bethell(4 years, 4 months ago)
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Lord Bethell [V]
My Lords, I completely share the concerns of the noble Baroness, Lady Andrews, about a second peak and we are working to prepare for that. I respect the views of the PAC and emphasise that our approach to PPE is incredibly serious. A huge amount of work has gone into it and a huge amount of progress has been made.
Baroness Browning (Con) [V]
Can my noble friend identify what lessons have been learnt so far from both the quantity and quality of the PPE that has been used in homes and hospitals? What action will be taken to minimise cross-infection for those who have to go into people’s domestic homes and who often work in more than one location?
Lord Bethell [V]
My Lords, the big lesson from Covid is that the quantity of PPE needed for a disease like this is massively more that could ever have been expected, particularly compared with our past experience. It has hit every country in the world and has hit the global supply chains incredibly hard. A benign lesson is that British manufacturers are capable of stepping up the challenge, and I salute their work. Contamination from itinerant workers was always one of the greatest challenges of the care sector, and we have put in a huge amount of work and financial resources to avoid the need for workers who move from home to home.
Hospitals: Patient Safety
Debate between Baroness Browning and Lord Bethell(4 years, 6 months ago)
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, despite Covid-19, the day-to-day health of the nation remains the business of the NHS. That is why the NHS has issued a new operating framework to help hospitals to continue providing essential and emergency care for patients who do not have Covid-19. This guidance is being kept under review. I have placed a copy of the framework in the Library.
Baroness Browning (Con)
Emergency admissions, of which we have seen many, though perhaps not enough, have resulted in people being very afraid of going into hospital, because there has been a lack of information for the general public. For example, what happens at the triage stage, what sort of PPE will people be wearing and how will they be protected? What can the Minister do to reassure the public that they will be safe and, on top of their emergency, will have the absolute minimum chance of getting Covid-19?
Lord Bethell
My Lords, I acknowledge that people’s concerns have led to a decline in attendance at A&E. That is why the NHS is running an “Open for business” media campaign, encouraging all patients in need of urgent or emergency medical care to seek appropriate treatment, including, where appropriate, attendance at A&E.